It's estimated that about a third of fertility issues experienced by couples are due to male factors.
Infertility is generally defined as actively trying to conceive a child for at least a year without a success. Male infertility can be caused by an obstruction in the male reproductive system or a non-obstructive problem affecting sperm production. T
here are several ways a urologist may diagnose male infertility and pinpoint a likely reason for it.
This is a sperm count test in which a collected sample is analyzed. The specimen may be collected at a urologist’s office or with a special condom during intercourse. A semen analysis look at three main factors. First, the number of sperm in the sample is determined to see if the reason for infertility is a low sperm count. The shape of the sperm and the way they move will also be evaluated.
If a man’s sperm count is excessively low, genetic test are usually done to determine if there’s a genetic reason. With such tests, a blood sample is taken. It will be examined to look for abnormalities with the Y chromosome. Genetic testing can help identify any congenital or inherited conditions that may be affecting fertility. This type of testing may also be recommended under the following circumstances:
A man has physical features suggesting a genetic abnormality, such misshapen or unusually sized testicles
Other possible causes of male infertility have been ruled out with various tests
The tube that carries sperm (vas deferens) cannot be felt during a physical examination of the scrotum and testicles
Fertility is also affected by certain glands, particularly ones produced by the testicles, pituitary gland, and hypothalamus. The hormones these glands produce can affect sperm production and development of the male reproductive system. A blood sample is taken and analyzed to measure hormone levels.
A scrotal ultrasound is done to check structures in the scrotum for signs of blockages, deformities, or other issues. During the test, high-energy sound waves are used to produce live images of tissues and internal structures. The test is primarily performed to look at the testicles, the tissues within the scrotum, and a tube by the testicles that collects sperm called the epididymis.
Another type of ultrasound that may be performed is a transrectal ultrasound. This type of visual assessment is done with a specialized wand inserted into rectum to check the prostate gland and nearby ejaculatory ducts and seminal vesicles.
After a likely cause of male infertility is determined or confirmed with a combination of the tests and procedures discussed here, a urologist will recommend an appropriate treatment plan. For some men, this may include making changes to medications being taken for other conditions, starting hormone treatments, or treating infections affecting the reproductive or urinary system. Surgery is sometimes done to correct structural defects or obstructions in the tubes that carry sperm or enlarged veins in the scrotum. Couples may also benefit from the transfer of sperm from the male into the female reproductive organs (assisted reproductive technology).